Foraminotomy now available at UC Davis

In May of this year, the UC Davis School of Veterinary Medicine welcomed Carter Judy, DVM, DACVS, to its faculty. With this, UC Davis is now able to offer foraminotomy to its equine patients, which is an extremely specialized surgery that fewer than a dozen veterinarians in the US can perform. The surgery is for equine patients with cervical foraminal stenosis, which is a narrowing of an intervertebral opening where the limb nerve root exits the spinal column.¹

Cervical foraminal stenosis can be caused by arthritis, bone spurs, disc herniation, or thickened ligaments and places compression on the patient's nerves that can be painful or cause numbness. This can then later develop into lameness and behavioral issues, such as ataxia, headshaking, and skipping gait. When veterinary professionals diagnose this condition, it generally occurs near the base of the neck where the cervical and thoracic vertebrae meet, meaning it requires a large-bore equine CT scanner. Not many hospitals have this equipment, UC Davis recently installed one in its All Species Imaging Center, and prior to this, the school only had a traditional scanner that did not allow for imaging beyond an equine patient’s head and distal limbs.

Before joining the faculty at UC Davis School of Veterinary Medicine, Carter performed this surgery for a year at his previous clinic, and continued to do so at UC Davis even without equine CT scanner thanks to imaging acquired from other hospitals.

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Scott Katzman, DVM, DACVS-LA, and Heidi Reesink, VMD, PhD, DACVS-LA, faculty surgeons at UC Davis, also completed training earlier this year to perform foraminotomies, which means the team at UC Davis can help more horse’s pain be alleviated. According to UC Davis, the hospital is now attracting clients from across the US due to the limited number of surgeons who perform this procedure.

Frida, a 4-year-old Oldenburg mare from Washington, was treated for the condition at UC Davis after osteoarthritis of multiple facet joints caused foraminal stenosis. Frida suffered from hind-limb weakness, range of motion, and coordination issues. After the surgery, all these conditions were corrected and she continues to improve.

Foraminotomy history

The first equine foraminotomy were performed on horses in Europe 5 years ago. Similar to the surgery performed on humans, that has been around for decades, the surgery is performed minimally invasively and uses endoscopic instruments to burr the foramen larger, which relieves the pressure compromises the nerve root. For many horses that have this surgery, they show improvement in less than 24 hours after the surgery.

The surgery was invented by a German veterinarian Jan-Hein Swagemakers and works by the veterinary professional inserting a specialized endoscope through a small incision on the patient. The procedure uses advanced endoscopy to safely remove excess bone to create more space and restore optimal nerve function.²

A study conducted by Swagemakers along with fellow veterinary professionals performed this procedure on 3 equine cadavers and in 2 clinical cases of patients with a history of forelimb lameness that was located in the caudal cervical region. The results of the study the horses had a smooth recovery from the surgery and at a follow up 12 months later, the clinical signs resolved completely without recurrence. The researchers did state that their main limitation for the study was the small number of clinical cases and absence of post-mortem examination or isopathy performed on the cadavers to assess possible iatrogenic injuries.³

However, the conclusion from the research was cervical spinal nerve decompression via minimal invasive foraminotomy is feasible in horses, but more research was needed at the time before researchers thought it could be recommended in clinical cases.³

Reference

1. Warren R. Foraminotomy surgery now available for horses at UC Davis. December 10, 2025. Accessed December 16, 2025. https://www.vetmed.ucdavis.edu/news/foraminotomy-surgery-now-available-horses-uc-davis
2. Endoscopic Foraminotomy for the Treatment of Spinal Nerve Compression. University of Florida College of Veterinary Medicine. Accessed December 16, 2025. https://largeanimal.vethospitals.ufl.edu/hospital-services/surgery/endoscopic-foraminotomy-for-the-treatment-of-spinal-nerve-compression/
3. Swagemakers JH, Van Daele P, Mageed M. Percutaneous full endoscopic foraminotomy for treatment of cervical spinal nerve compression in horses using a uniportal approach: Feasibility study. Equine Vet J. 2023;55(5):788-797. doi:10.1111/evj.13919